Rhematology

Question 1

Acute attack treatment for gout

Answer 1

1) NSAIDS- best initial therapy
2) corticosteroids
3) if can’t use NSAIDS or steroids then colchine

Question 2

side effects of colchicine

Answer 2

diarrhea and bone marrow WBC supression ( neutropenia)

Question 3

Drugs to avoid in gout

Answer 3

thiazides
niacin
aspirin

Question 4

Best Bp med in gout

Answer 4

losartan

Question 5

Pain worse when walking downhill, radiates into buttocks and thighs

Answer 5

lumbar spinal stenosis

Question 6

anterior knee pain secondary to trauma worse just after starting walking after being seated for prolonged period. pain is particularly bad when going up and down stairs, normal x rays

Answer 6

pateollofemoral syndrome

Question 7

Rhematoid arthritis
splenomegaly
neutropenia

Answer 7

Felty syndrome

Question 8

Rheumatoid arthritis
pneumoconiosis
lung nodules

Answer 8

caplan syndrome

Question 9

what are the adverse effects for methotrexate

Answer 9

liver toxicity
bone marrow suppression
pulmonary toxicity

Question 10

you want to use TNF inhibitor such as infliximab, adalimumab, etanercept- what should you check before hand?

Answer 10

PPD- bc can cause reactivation of TB

Question 11

Hydroxycholoroquine toxicity causes what?

Answer 11

retinal toxicity

Question 12

presence of high spiking fevers in a young person with a salmon colored rash on chest and abdomen

Answer 12

juvenile rhematoid arthritis ( adult still disease)

Question 13

what lab changes do you see that are specific for SLE flare?

Answer 13

complement levels drop and anti DS DNA levels rise

Question 14

Antiphospholipid syndrome has as an elevated PT or PTT?

Answer 14

PTT

Question 15

best initial test for antiphospholid syndrome?

Answer 15

mixing study- PTT will remain elevated in APL syndrome

Question 16

most dangerous complication of sjogren

Answer 16

lymphoma

Question 17

best inital test for sjogren?

Answer 17

schirmer test

Question 18

best accurate test for sjogren?

Answer 18

lip or parotid gland biopsy

Question 19

antibodies in sjogren

Answer 19

ro and la

Question 20

antibodies in scleroderma

Answer 20

scl 70

Question 21

what should be tested for in polyarteritis nodosa

Answer 21

hep b and c

Question 22

unresolving pneumonia not better with antibiotics?

Answer 22

wegener

Question 23

antibodies associated with wegners

Answer 23

C ANCA

Question 24

term leukocytoclastic vasculitis on biopsy

Answer 24

henoch schonlein purpura

Question 25

complication of Henoch scholein purpura

Answer 25

intussusception

Question 26

what is cryoglobulins associated with?

Answer 26

hep C

Question 27

joint pain, glomerulonephritis, purpuric skin lesions neuropathy and history of Hep C

Answer 27

cryoglobulins

Question 28

asian or middle eastern person with painful oral and genital ulcers, painful nodules on skin, ocular lessions, arthritis

Answer 28

Behcets

Question 29

pencil in cup deformity

Answer 29

psoriatic arthritis

Question 30

treatment for psoriatic arthritis

Answer 30

1) NSAIDS
2) methotrexate
3) anti TNF

Question 31

Triad of joint pain, ocular findings, genital abnormalities secondary to IBD, STD GI infections

Answer 31

reiters syndrome

Question 32

most common organism that is involved in septic arthritis of recently placed artificial joints

Answer 32

Staphylococcus epidermidis

Question 33

what should you test for in recurrent gonorrheal infection

Answer 33

terminal complement deficiency

Question 34

radial tunnel syndrome

Answer 34

s/s similar to lateral epicondylitis,
tenderness over lie the extensor muscles
pain elicited by flexing the patients long finger while patient actively extends the finger and wrists.

Question 35

mood stabilizers

Answer 35

lithium
lamotrigine
valproate

Question 36

antipsychotis

Answer 36

aripiprazole
olanzapine
quietapine
risperidone
zipradisone